As we age, our bodies go through a lot of changes including the brain. Aging often causes us to experience normal changes in memory such as losing our car keys, recalling someone’s name and forgetting an appointment. Although subtle memory changes are normal, if memory loss disrupts your daily life or ability to function this could be a warning sign of a more serious problem such as Alzheimer’s or other dementia.

While there is no surefire way or magic pill to prevent cognitive decline, research suggests certain activities do play a role in improving overall brain function and health.

Simple Tips to Improve Your Memory:

• Physical Exercise:  Physical activity can lower your risk of memory loss by increasing blood flow throughout your body including your brain. Older adults should get at least 2.5 hours of moderate aerobic exercise every week.
• Mental Exercise:  Stimulate your brain with challenging activities at least once or twice a week. Learn a new language, play a new instrument, try a new hobby or craft.
• Diet:  Maintain a healthy diet that includes fruits, leafy green vegetables, whole grains, and Omega-3 fatty acids like fish, walnuts and soy beans.
• Stress:  Protect yourself from stress which can negatively impair memory and cognitive function in the brain. Focus on ways to relax such as yoga, tai chi, deep breathing, and meditation.
• Sleep:  Quality sleep is the most important thing you can do to reset your brain and allow it to heal and restore mental health. (7-8 hrs of sleep recommended for people age 65+)

If you are having problems with completing daily tasks, comprehending and/or expressing thoughts, please talk to your doctor. Ask your doctor if therapy could benefit you. Our therapy team can discuss the role of therapy in dementia and benefits of physical, occupational and speech therapy.

The Office of Inspector General (OIG) 2020 workplan includes residents who were receiving Medicaid nursing home care and then were hospitalized. The beneficiary then returned to the same facility and received Medicare covered post-hospital SNF care. In some cases, hospital physicians discharged beneficiaries to home rather than the SNF, yet nursing facility physicians certified that skilled care was needed. Because Medicare pays substantially more for SNF care than Medicaid for nursing home care, nursing home facilities have financial incentives to increase the level of skilled care. This will be the focus of OIG medical review.

What will the OIG use to determine if the post-hospital SNF care is dually eligible?

• the SNF level of care was certified by a physician (e.g., a hospital or SNF physician) or a physician extender (i.e., a nurse practitioner, clinical nurse specialist, or physician assistant);
• the condition treated at the SNF was a condition for which the beneficiary received inpatient hospital services or a condition that arose while the beneficiary was receiving care in a SNF for a condition for which the beneficiary received inpatient hospital services;
• daily skilled care was required
• the services delivered were reasonable and necessary for the treatment of a beneficiary’s illness or injury; and
• improper Medicare payments were made on the claims we review. We will also determine whether any of the hospital admissions we review were potentially avoidable

Prepare for the 2020 OIG Work Plan:

• Develop policies and procedures related to admission and determination of appropriate level of care and individualize them for your facility.
• Assure your process for attaining hospital records is timely. This is crucial for not only response to OIG review requests but also for timely PDPM processes including identifying NTA components.
• Review your facility’s communication for medical review. Did you know HTS partners with a third-party company to complete medical reviews on your behalf? Ask us about our Denials Management Processes today!

Bottom Line: There is a very short timeframe for response.

• Hospital discharge records requested within 7 days and remaining documents within 15 days
• Specific policies and procedures must be submitted for review as well as facility specific questions related to determining level of care:
  • Policies and procedures related to admission of patients into SNF care
  • Policies and procedures related to determination of appropriate level of care (unskilled/custodial care and skilled care)

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